Personal Information
Family/Last Name or Surname: First or Given Name: Preferred Name: Former last name if different from current: Overseas Current Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Permanent or Summer Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Gender: Male Female Date Of Birth: Email Address: Home Phone: Alternate Phone: Cell Phone: Have you previously applied to Carson-Newman College: Yes No If yes, and admitted please list Term/Year:
Family/Last Name or Surname:
First or Given Name:
Preferred Name:
Former last name if different from current:
Gender: Male Female
Date Of Birth:
Email Address:
Home Phone:
Alternate Phone:
Cell Phone:
Have you previously applied to Carson-Newman College: Yes No If yes, and admitted please list Term/Year:
Major: Year plan to Enroll: I plan to Enroll as a: Re-Admit First-time Freshman Undergraduate Transfer Second Bachelor’s Degree Transient/Visiting Student/Non-Degree /Audit English Language Institute Student I am applying for a full course of study (12 or more hours) to begin in one the following terms: Fall (August – December) Spring (January – May) Summer (May-July) Other Term if selected other term: If you are applying for a course of study less than 12 hours please list: Course Name & Description I am applying for admission to the: Full Undergraduate Program Conditional Undergraduate Program English Language Institute Other if selected other: I plan to (check one of the following): ELI Complete the ELI program Complete the ELI program and pursue further studies at C-N Attend one ELI term Spring Attend one ELI term Fall Attend one ELI term Summer Undergraduate Complete an undergraduate program (Receive a Degree) Attend one undergraduate term Spring Attend one undergraduate term Fall Attend one undergraduate term Summer Transfer Transfer credits from a past or current university/college to Complete an undergraduate program (Receive a Degree) Post-Bac Undergraduate Complete a Health Pre-Professions undergraduate program Complete a Pre-Engineering undergraduate program Complete a Pre-Law undergraduate program Re-Admit Re-Admit into an undergraduate program Re-Admit into the ELI program Re-Admit into into Post-Bac program as a graduate of C-N: Date of Graduation from CNC Other Program Attend a special program not listed above:
Major:
Year plan to Enroll:
I plan to Enroll as a: Re-Admit First-time Freshman Undergraduate Transfer Second Bachelor’s Degree Transient/Visiting Student/Non-Degree /Audit English Language Institute Student
I am applying for a full course of study (12 or more hours) to begin in one the following terms: Fall (August – December) Spring (January – May) Summer (May-July) Other Term if selected other term:
If you are applying for a course of study less than 12 hours please list: Course Name & Description
I am applying for admission to the: Full Undergraduate Program Conditional Undergraduate Program English Language Institute Other if selected other:
I plan to (check one of the following):
ELI Complete the ELI program Complete the ELI program and pursue further studies at C-N Attend one ELI term Spring Attend one ELI term Fall Attend one ELI term Summer Undergraduate Complete an undergraduate program (Receive a Degree) Attend one undergraduate term Spring Attend one undergraduate term Fall Attend one undergraduate term Summer Transfer Transfer credits from a past or current university/college to Complete an undergraduate program (Receive a Degree) Post-Bac Undergraduate Complete a Health Pre-Professions undergraduate program Complete a Pre-Engineering undergraduate program Complete a Pre-Law undergraduate program Re-Admit Re-Admit into an undergraduate program Re-Admit into the ELI program Re-Admit into into Post-Bac program as a graduate of C-N: Date of Graduation from CNC Other Program Attend a special program not listed above:
Undergraduate Complete an undergraduate program (Receive a Degree) Attend one undergraduate term Spring Attend one undergraduate term Fall Attend one undergraduate term Summer
Transfer Transfer credits from a past or current university/college to Complete an undergraduate program (Receive a Degree)
Post-Bac Undergraduate Complete a Health Pre-Professions undergraduate program Complete a Pre-Engineering undergraduate program Complete a Pre-Law undergraduate program
Re-Admit Re-Admit into an undergraduate program Re-Admit into the ELI program Re-Admit into into Post-Bac program as a graduate of C-N: Date of Graduation from CNC
Other Program Attend a special program not listed above:
Please provide two different contacts below Contact 1 Father Mother Spouse USA Contact Last Name: First Name: Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Email Address: Home Phone: Alternate Phone: Cell Phone: Contact 2 Father Mother Spouse USA Contact Last Name: First Name: Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Email Address: Home Phone: Alternate Phone: Cell Phone: Will you bring any dependents (spouse or child) with you? Yes No If yes, please include their names, counties of citizenship, dates of birth, and relationship to applicant: I plan to live On Campus Off Campus Please be advised that if you choose to live off campus, Carson-Newman College is not responsible for finding you housing.
Please provide two different contacts below
Contact 1 Father Mother Spouse USA Contact Last Name: First Name: Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Email Address: Home Phone: Alternate Phone: Cell Phone:
Father Mother Spouse USA Contact
Last Name:
First Name:
Contact 2 Father Mother Spouse USA Contact Last Name: First Name: Mailing Address: Street address City County State Country Postal Code * Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form. Email Address: Home Phone: Alternate Phone: Cell Phone:
Will you bring any dependents (spouse or child) with you? Yes No If yes, please include their names, counties of citizenship, dates of birth, and relationship to applicant:
I plan to live On Campus Off Campus Please be advised that if you choose to live off campus, Carson-Newman College is not responsible for finding you housing.
Passport Number or United States Social Security Number (if a US Citizen): Country of Origin/Birth: City of Birth: Countries of Citizenships: Country of Legal Permanent Residence: Do you currently possess an immigration visa? Yes No If yes: Date Of Issue: Date Of Expiration: Port of Entry: Date of Entry: If you are currently in the U.S. on a Non-immigrant Visa other than a F-1, please indicate if you would like to apply for a change of status to an F-1 Student Visa? Yes No If you are currently in the U.S. on an F-1 Visa, please list below the name of the U.S. institution issuing your current Form I-20//DS-2019:
Passport Number or United States Social Security Number (if a US Citizen):
Country of Origin/Birth:
City of Birth:
Countries of Citizenships:
Country of Legal Permanent Residence:
Do you currently possess an immigration visa? Yes No If yes: Date Of Issue: Date Of Expiration: Port of Entry: Date of Entry:
If you are currently in the U.S. on a Non-immigrant Visa other than a F-1, please indicate if you would like to apply for a change of status to an F-1 Student Visa? Yes No
If you are currently in the U.S. on an F-1 Visa, please list below the name of the U.S. institution issuing your current Form I-20//DS-2019:
What type of diploma did you most recently receive? (In original language): Native Language (List all that apply): Primary language spoken at home (List all that apply): Languages spoken (List all that apply): Are you currently enrolled in the Carson-Newman College English Language Institute? Yes No If you have taken the TOEFL/TWE, IELTS or STEP please list: Test Name: Date taken: Score: Please note only official scores sent from a testing center will be accepted for application. Do you wish to take the Carson-Newman College English Language Placement exam in place of the required TOEFL, IELTS, or STEP exam? Yes No If you attended high school overseas, what type of exams did you sit? A-level GCE O-level GCE West African Exam General Secondary Certificate High school or secondary school from which you graduated or will graduate: School Name Country code/City code/School Number City, State Country Date of Graduation (month/year) Please list honors/awards received and extracurricular activities: College/University Information (List All that Apply): Institution City, State, Province, Country Date of Attendance (month/year to month/year) Degree Earned Approximate number of hours:
What type of diploma did you most recently receive? (In original language):
Native Language (List all that apply):
Primary language spoken at home (List all that apply):
Languages spoken (List all that apply):
Are you currently enrolled in the Carson-Newman College English Language Institute? Yes No
If you have taken the TOEFL/TWE, IELTS or STEP please list: Test Name: Date taken: Score: Please note only official scores sent from a testing center will be accepted for application.
Do you wish to take the Carson-Newman College English Language Placement exam in place of the required TOEFL, IELTS, or STEP exam? Yes No
If you attended high school overseas, what type of exams did you sit? A-level GCE O-level GCE West African Exam General Secondary Certificate
High school or secondary school from which you graduated or will graduate: School Name Country code/City code/School Number City, State Country Date of Graduation (month/year)
School Name Country code/City code/School Number City, State Country Date of Graduation (month/year)
Please list honors/awards received and extracurricular activities:
Institution City, State, Province, Country Date of Attendance (month/year to month/year) Degree Earned Approximate number of hours:
T-shirt size: Small medium larger x-large xx-large How did you hear about Carson-Newman College? Do you have relatives who attend or have attended Carson-Newman College? Yes No If so, what is the relationship to you? If not with both parents, with whom do you make your permanent residence? Are you preparing for a full-time Southern Baptist church related vocation? Yes No Are you a dependent of a full-time or bi-vocational Southern Baptist minister/missionary? Yes No Please explain any special circumstances that should be taken into consideration when reviewing your application for financial assistance: Are you currently on probation, parole, or under court restriction, or have you ever been convicted of a criminal offense other than a minor traffic violation? Yes No Has any academic or disciplinary action been taken against you at any college or university previously attended? Yes No If you answered yes to either question, please submit explanation with this application:
T-shirt size: Small medium larger x-large xx-large
How did you hear about Carson-Newman College?
Do you have relatives who attend or have attended Carson-Newman College? Yes No If so, what is the relationship to you?
If not with both parents, with whom do you make your permanent residence?
Are you preparing for a full-time Southern Baptist church related vocation? Yes No
Are you a dependent of a full-time or bi-vocational Southern Baptist minister/missionary? Yes No
Please explain any special circumstances that should be taken into consideration when reviewing your application for financial assistance:
Are you currently on probation, parole, or under court restriction, or have you ever been convicted of a criminal offense other than a minor traffic violation? Yes No
Has any academic or disciplinary action been taken against you at any college or university previously attended? Yes No
If you answered yes to either question, please submit explanation with this application:
I hereby certify that all information given on this application is true and correct. Upon my acceptance, I agree to comply with all rules, regulations, and policies of Carson-Newman College as stated in the college catalog and student code of conduct. Failure to comply with college policies may result in disciplinary actions.
By clicking the submit button, you agree that you have read, understood, and agreed with the above statements.
